Athanasios Stratos

Rehabilitation of partially edentulous patients following fibular free-flap reconstruction presents significant functional and biomechanical challenges due to altered soft tissue morphology, reduced vestibular depth, and compromised load-bearing capacity. In cases involving extensive tissue loss, fixed prosthetic designs may be limited in their ability to support the tongue and cheeks, while implant-assisted removable partial dentures (IARPDs) offer better hygiene access and prosthetic flexibility. This case report describes a prosthetically driven approach that integrates CBCT-guided planning with advanced conventional prosthodontic techniques. After the fibula and overlying skin graft had sufficiently healed, a customized impression protocol was used to accommodate the irregular, highly resilient grafted soft tissues. Denture tooth placement was guided by the neutral zone concept to ensure functional harmony with the surrounding muscles. A radiographic splint with barium sulfate markers enabled prosthetically guided implant planning, resulting in the placement of three implants using a fully guided approach. A removable partial denture retained by stud attachments was selected, given the extent of tissue loss and the need for improved peri-implant hygiene. Intraoral activation of the attachments stabilized the distal extension during functional loading. Because the grafted tissues were mobile, a functional impression was performed to accurately capture the prosthetic-bearing area and facilitate relining, as conventional selective pressure techniques are insufficient in such conditions. The definitive prosthesis demonstrated improved retention, occlusal harmony, and functional stability, resulting in greater patient comfort and masticatory efficiency. This case highlights the potential value of prosthetically driven planning, functional impression techniques, and neutral zone-guided tooth placement in supporting functional rehabilitation and favorable clinical outcomes in reconstructed mandibles after oncologic resection.

The COVID-19 pandemic has exposed significant vulnerabilities among older adults, particularly denture wearers, to opportunistic fungal infections, including mucormycosis and oral candidiasis. This narrative review, following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Narrative Reviews) guidelines, collected evidence from 2020 to 2025 to examine the connection between denture use, systemic comorbidities, and fungal complications in elderly individuals after COVID-19. A total of 21 of 104 studies were included, covering case-control, cross-sectional, cohort, and retrospective studies from India, Europe, the Middle East, and North America. Several studies have reported higher rates of oral fungal colonization among denture wearers,with Candida albicans being the most frequently isolated species, followed by resistant strains such as Candida auris. However, these observations are primarily derived from heterogeneous observational studies and should therefore be interpreted as associative rather than causal. COVID-19-related mucormycosis (CAM) was primarily reported as rhino-orbito-cerebral disease, with oral manifestations including palatal necrosis, gingival ulcers, and tooth mobility. Key risk factors identified include diabetes mellitus, corticosteroid therapy, prolonged intensive care unit (ICU) stays, and poor denture hygiene. Mortality related to CAM ranged from 18% to 56%, while candidiasis, though less deadly, significantly affected oral function, nutrition, and overall quality of life. Diagnostic methods included clinical and intraoral examinations, microbiological cultures, imaging techniques, and emerging salivary biomarkers. Treatments included systemic antifungal medications, surgical removal, and prosthesis disinfection, highlighting the important role of prosthodontists in prevention and rehabilitation. Knowledge gaps remain regarding the predictive value of oral lesions for systemic infections, the long-term effects of COVID-19 on the oral microbiome, and the need to standardize denture hygiene protocols. This review emphasizes the importance of integrated dental and medical care in reducing morbidity and mortality among denture-wearing older adults recovering from COVID-19, while recognizing that early oral findings may serve as warning indicators rather than definitive predictors of systemic infection.

Osteopetrosis is a rare hereditary disorder characterized by impaired osteoclastic bone resorption, resulting in generalized skeletal sclerosis, increased bone fragility, and a heightened risk of complications such as osteomyelitis. Prosthodontic rehabilitation in pediatric patients is particularly challenging due to ongoing craniofacial growth, incomplete dental development, and the need to avoid invasive procedures. A pediatric patient with osteopetrosis presented with mandibular Kennedy Class I, Modification I partial edentulism, misalignment of the maxillary teeth, and dentition at varying stages of development. A conservative removable prosthodontic approach was selected. Following tissue conditioning, a functional “washout” impression using a soft liner was performed to record the supporting tissues while minimizing pressure. To permit flexibility and future modification during growth, a removable partial denture (RPD) without a metal framework was fabricated. The impression surface was digitized using an intraoral scanner (TRIOS, 3Shape, Copenhagen, Denmark). The scan data guided computer‐aided design and milling of a new RPD from a monolithic polymethyl methacrylate (PMMA) disk (Ivotion, Ivoclar Vivadent AG, Schaan, Liechtenstein). The tissue‐borne prosthesis was extended to maximize support and contoured around the canines to provide encirclement and reciprocation, enhancing stability and retention while reducing stresses on abutment teeth. The digitally fabricated denture demonstrated an accurate intaglio fit, minimal intraoral adjustments, and improved esthetics and masticatory function. Its design allowed repeated tissue conditioning, incremental adaptation, and modifications to accommodate craniofacial growth. All digital scans were archived, enabling longitudinal superimposition to monitor growth‐related changes and facilitate early identification of pressure areas or sites at risk for osteomyelitis. Recall appointments were essential for growth adjustments and monitoring. Within the limitations of this case, an acrylic resin RPD without a metal framework represents a functional and adaptable interim solution for pediatric patients with osteopetrosis. The integration of digital workflows supports long‐term follow‐up and early complication detection during growth.

Purpose: To assess survival and success rates, as well as technical and biological complications of structurally compromised teeth when these were restored with either all ceramic endocrowns or all ceramic conventional crowns with or without post and core. Method: A focused PICO question was ...